The deformation of Valgus from the first finger (thumb) is an orthopedic pathology, in which the finger is deformed, deviating itself.Especially the disease occurs in women after 30 years.In 3%, Valgus deformation is detected in people aged 15 to 30, in 9% in those who are 31 to 60 and 16% in people over 60.The problem causes not only strong aesthetic discomfort, but also causes a change in all ligaments, tendons, joints and foot bones.
Pathogenesis
With the deformation of the first finger valgus, the angle between the first and second bones becomes more advantage, the change of the first metatarsal bone is observed.The thumb of the foot changes out, and the bone head stands out, forming a bone.This bone does not allow the thumb to correspond to the norm and gradually deviates out.The tuber (bone) prevents you from wearing shoes, creates inflammation, friction and leads to inflammation of the first metatarsophalangic joint.Gradually, the bone swells and is inflamed, painful.Inadequate joint position causes its premature wear, cartilage injury and an increase in bone growth size.This, in turn, causes the trauma of the foot and the additional development of the pathology.As the disease advances, the thumb changes the remaining fingers of the foot, leading to its deformation in the form of a hammer.AS The Disease Develops, It Leads to Arthrosis of the Plusnoplange Joints, Fiemation of the Articular Bags, The Joints of the Fingers, Chronic Infummation of the First Metatarsophalangeal Joint, The Displacement of the First Metatarsal Bone, Flat Pedes (Chronic and Transverse), Bone and TransverseCartilage Augmentum Head Metatarsal Bones.
Forms
In normal state, metatarsal bones are parallel to each other.Under the influence of certain reasons, the first metatarsal bone deviates, so a small swelling appears on the foot, ligaments and tendons lose its elasticity, its dysfunction develops.
The disease passes several stages:
- Early.At this stage, the diversion of the thumb of the foot is less than 15 degrees.
- Average.The deviation of the first finger to the side is 15 to 20 degrees.At the same time, second finger deformation is observed.It rises above the thumb and becomes a form for a hammer.
- Heavy.The diversion of the thumb is 30 degrees.All fingers of the foot have already been deformed and, at the base of the first phalanx, there is great bone growth.In places where there is a great tension of the foot, the gross calluses appear.
Reasons
The main provocative factor in the appearance of Valgus deformation is the irregular shoes.If a person wears tight shoes with a narrow or tall foot finger, the fingers are constantly in the wrong position (compacted), which contributes to the development of Valgus deformation.But not only does this become the cause of disease development.The following reasons affect the appearance of pathology:
- traumatic damage to the leg and foot;
- rickets;
- Cerebral palsy;
- Polyneuropathy;
- low bow of the foot;
- Smooth feet;
- Congenital weakness of the muscle-muscle tract;
- Chronic joint inflammation caused by psoriasis;
- arthritis;
- Multiple sclerosis (accompanied by damage to the nerve fiber shell);
- Diabetes mellitus;
- gout (deposition of urats in body tissues);
- Hyper of joint mobility observed during Marthans and Down syndrome;
- Young foot (fast increase in foot size in the teenage period);
- Charcot-Mari-tute disease (hereditary neuropathy, accompanied by atrophy of the muscles of the distal limbs);
- osteoporosis (bone loss);
- Stop overcoming in connection with professional activities (waiters, athletes, dancers).
In the presence of provocative factors, the disease progresses rapidly.
Symptoms
The symptoms of pathology depend on the degree of damage to the foot.In the first stage, redness, swelling of the tissues in the appearance of the bone, pain in the phalanx of the fingers is intensified during the walk.In the middle stage of disease development, pain, swelling, bone growth in the positive bone area, dry corn under the middle phalanx of the finger appear.In the heavy scenario on the sole of the foot and the thumb, serious and tiring pains appear.Dry grains are formed and skin keratinization appears under the second and third phalanges of the fingers.
Diagnosis
Diagnostic measures begin with the patient's anamnesis collection.The doctor asks him about disturbing symptoms, is interested in causing his appearance (leg load, walking, tight shoes), there are metabolic and systemic diseases in medical history, lower extremity injuries, bone hereditary diseases.Then an external inspection is performed during which a person is requested to pass.The doctor observes the patient's march, determining the intensity of the pain.The position of the thumb of the foot is studied, its location in relation to other fingers, explore the reach of its flexion and extension.The presence of other external symptoms (swelling, redness, thickening of the stratum layer under the bones of the fingers) is verified.Foot Footenography is performed in three projections in order to identify the degree of foot deformation, displacement of joint and related pathologies.An ultrasound of the vessels is performed to exclude circulatory disturbances in the legs.
Treatment
Valgo deformation therapy from the foot thumb is traditional and operational.In the early stages, when you can run out of surgery, doctors advise you to choose convenient and correct shoes.It should not please the load in the foot, friction.Comfortable shoes decrease the progression of the disease.At the same time, the doctor will advise buying special orthopedic devices:
- Together to the thumb joint bag (they eliminate shoes pressure);
- Intodassen Rollers, spacers that contribute to the correct distribution of the load on the foot.
All orthopedic devices reduce pain, but it is impossible to completely get rid of discomfort with your help.To eliminate pain and inflammation, non -steroid anti -inflammatory drugs, corticosteroid injections are used.To relieve spasms and restore joint mobility, massage and special gymnastics are prescribed to relax the feet.
The effectiveness of physiotherapy
An important role in the treatment of Valgus deformation is played by physical therapy.To eliminate the disease, doctors prescribe electrophoresis with calcium, hydrocortisone phonophoresis, paraffin and ozoceritic applications.One of the most effective methods for eliminating deformationFrom Valgo do Polega do Pé is the therapy with Shock Waves (UVT).This procedure implies a short -term effect on the painful zone with low frequency acoustic pulses.With the help of the UVT, the symptoms of pain are eliminated, the effects on factors that contribute to their appearance are obtained.The procedure is performed using a special device that generates shockwaves.They only affect pathological areas without affecting healthy tissues.With the help of ultrasound, metabolic processes improve.The UVT is not performed in the presence of neurological, infectious, oncological, heart, somatic, diabetes mellitus, blood coagulation disorders.Shockwave therapy is not prescribed for pregnant women, women and children under 18.The effect of the procedure is observed after several procedures.The pain disappears, it is easier to walk.But it is impossible to completely remove the salient bone using an UVT procedure.The doctor can prescribe at least 5-7 sessions.Depending on the stage of the disease, the procedure for performing procedures is also prescribed.Some people receive daily prescribed sessions, others will be enough for one procedure per week.The result of UVT treatment is maintained for a long period.
Surgical treatment
With a medium and severe degree of deformation of the foot in the foot, the surgical treatment is prescribed.To eliminate pathology, many methods were developed by which the following objectives achieve:
- eliminate bursitis from the first finger;
- Curved muscles located around the damaged joint to prevent the disease from relapse;
- Perform the reconstruction of the thumb bones.
If the deformation is not strongly expressed, growth in the growth in the joint exchange through a small incision will be removed.After the operation, a person needs rehabilitation, with the mandatory use of a dressing or shoes with a wood sole using foot reviewers, physical therapy (at least 6 procedures).Currently, with the deformation of Valgus do Thumb, the following operations are performed:
- Small deformation correction.Small cuts are made on both sides of the thumb, through which, with the help of miniature mills, the position of metatarsal bones and the phalanx of the finger.
- Chevron-Oosteotomy.The operation is performed with a finger deviation no more than 17 degrees.Growth is excised and the thumb phalanx is fixed with a screw and a titanium wire.After a while, the structure is removed.
- Scarf ooteotomy.The operation is performed if the thumb deviation angle is 18 to 40 degrees.During the intervention, using manual exposure, the position of the metatarsal bones is corrected and then repair with two titanium screws.
The protruding bone of the foot thumb is not only aesthetically ugly, but it also causes many inconvenience when walking.The disease that has not finished treating leads to complications in the work of the entire musculoskeletal system.Therefore, everything should not be allowed on a march and contact an orthopedic if the first signs of deformation appear